Intravascular delivery system and method for percutaneous coronary intervention including perfusion

Abstract

The subject guide catheter extension/pre-dilatation system includes an outer delivery sheath, an inner member extending within the sheath, and a mechanism for engagement/disengagement of the inner member to/from the sheath. The inner member is configured with a tapered distal tip having a delivery micro-catheter and a pre-dilatation balloon member attached to the tapered distal tip in proximity to the micro-catheter. The outer delivery sheath and the inner member are modified for different engagement/disengagement mechanisms operation. The outer delivery sheath comprises one or more holes configured to reduce or eliminate myocardial ischemia risk.

What is claimed is: 
     
         1 . An intravascular delivery system comprising:
 an outer member formed by a sheath defining a sheath lumen having a proximal end and a distal end, wherein the sheath comprises one or more holes;   an inner member having an elongated body, wherein the inner member is configured to extend internally along the sheath lumen of the outer member.   
     
     
         2 . The intravascular system of  claim 1 , wherein the one or more holes extend from an outer surface to the sheath lumen of the sheath. 
     
     
         3 . The intravascular system of  claim 1 , wherein the sheath comprises:
 a proximal section, a distal section, and a middle section extending between and interconnecting the proximal section of the sheath and the distal section of the sheath,   wherein the one or more holes are positioned in the proximal section of the sheath.   
     
     
         4 . The intravascular system of  claim 1 , wherein the sheath comprises:
 a proximal section, a distal section, and a middle section extending between and interconnecting the proximal section of the sheath and the distal section of the sheath,   wherein one or more holes are positioned in the proximal section of the sheath and one or more holes are positioned in the distal section of the sheath.   
     
     
         5 . The intravascular system of  claim 1 , wherein the sheath comprises:
 a proximal section, a distal section, and a middle section extending between and interconnecting the proximal section of the sheath and the distal section of the sheath,   wherein one or more holes are positioned in the middle section of the sheath and one or more holes are positioned in the distal section of the sheath.   
     
     
         6 . The intravascular system of  claim 1 , wherein the one or more holes are positioned to permit a fluid to flow in a direction substantially from a proximal section of the sheath substantially toward a distal section of the sheath. 
     
     
         7 . The intravascular system of  claim 1 , wherein the one or more holes are circular shaped. 
     
     
         8 . The intravascular system of  claim 1 , wherein the one or more holes comprises a plurality of holes, wherein a single axial position on the sheath comprises the plurality of holes. 
     
     
         9 . The intravascular system of  claim 1 , wherein the one or more holes comprises a plurality of holes which have the same diameter or cross-sectional dimension. 
     
     
         10 . The intravascular system of  claim 1 , wherein the one or more holes comprises a plurality of holes which are circumferentially arranged. 
     
     
         11 . The intravascular system of  claim 1 , wherein the one or more holes comprises a plurality of holes which are longitudinally arranged. 
     
     
         12 . The intravascular system of  claim 1 , wherein the one or more holes comprises a plurality of holes in a proximal section of the sheath. 
     
     
         13 . The intravascular system of  claim 1 , wherein the one or more holes comprises a plurality of holes in a distal section of the sheath. 
     
     
         14 . The intravascular system of  claim 1 , wherein the sheath comprises a middle section without any holes. 
     
     
         15 . The intravascular system of  claim 1 , wherein the sheath comprises a proximal section without any holes. 
     
     
         16 . The intravascular system of  claim 1 , wherein the sheath comprises a distal section without any holes. 
     
     
         17 . The intravascular system of  claim 1 , wherein the sheath comprises continuous holes. 
     
     
         18 . The intravascular system of  claim 1 , wherein the one or more holes are configured to reduce or eliminate myocardial ischemia risk. 
     
     
         19 . The intravascular system of  claim 1 , wherein the one or more holes promote perfusion. 
     
     
         20 . The intravascular system of  claim 1 , wherein a tapered outer tip of the outer member is an elastomeric tapered outer tip. 
     
     
         21 . The system of  claim 1 , wherein the sheath is reinforced along the length thereof. 
     
     
         22 . The system of  claim 1 , wherein the inner member further comprises a balloon member attached to a tapered distal portion of the inner member in proximity to a tapered delivery micro-catheter.